Salikhanov Islam, Koechlin Luca, Gahl Brigitta, Zellweger Michael J, Haaf Philip, Müller Christian, Berdajs Denis
Department of Cardiac, Surgery, University Hospital Basel, 4031 Basel, Switzerland.
Department of Cardiology, University Hospital Basel, 4031 Basel, Switzerland.
J Clin Med. 2024 Sep 18;13(18):5514. doi: 10.3390/jcm13185514.
: The objectives of this paper are to evaluate the incidence of early graft occlusion during hospital stays following coronary bypass surgery (CABG) and to assess the factors influencing the odds of in-hospital early graft occlusion. : Reports evaluating the early in-hospital occlusion of coronary bypass grafts were identified through PubMed, Embase, and Cochrane databases. The primary endpoint was to determine the incidence of early graft occlusion following CABG before discharge and to identify and quantify the impact of demographic, clinical, and procedural risk factors on the occurrence of early graft occlusion. The meta-analysis was conducted using a random-effects inverse-variance model with the DerSimonian-Laird estimator, assessing incidence rates, risk factors, and study heterogeneity, with statistical analysis performed using Stata. : A total of 22 studies with 35,798 patients were included in the analysis. The overall incidence of in-hospital early graft occlusion was 5% (95% CI: 3% to 7%). In studies using symptom-driven patency assessment, the incidence of occlusion was 2%, whereas in those employing systematic graft patency assessment, it was 6%. Only the presence of a vein graft OR 2.13 (95% CI: 1.19-3.82) was significantly associated with in-hospital graft occlusion. : The incidence of in-hospital early graft occlusion seems substantially underestimated if imaging is restricted only to symptomatic patients. Moreover, female gender, increased PI, and the presence of a composite graft could also be potential risk factors for this complication.
本文的目的是评估冠状动脉搭桥手术（CABG）后住院期间早期移植物闭塞的发生率，并评估影响院内早期移植物闭塞几率的因素。通过PubMed、Embase和Cochrane数据库检索评估冠状动脉搭桥移植物早期院内闭塞的报告。主要终点是确定CABG术后出院前早期移植物闭塞的发生率，并识别和量化人口统计学、临床和手术风险因素对早期移植物闭塞发生的影响。采用DerSimonian-Laird估计器的随机效应逆方差模型进行荟萃分析，评估发生率、风险因素和研究异质性，使用Stata进行统计分析。分析纳入了22项研究，共35798例患者。院内早期移植物闭塞的总体发生率为5%（95%CI：3%至7%）。在使用症状驱动通畅性评估的研究中，闭塞发生率为2%，而在采用系统性移植物通畅性评估的研究中，发生率为6%。只有静脉移植物的存在（OR 2.13，95%CI：1.19 - 3.82）与院内移植物闭塞显著相关。如果成像仅局限于有症状的患者，院内早期移植物闭塞的发生率似乎被严重低估。此外，女性、PI升高和复合移植物的存在也可能是该并发症的潜在风险因素。
